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The Beautiful Sound of Medical Communication

Family trauma reshapes the career of Elisabeth Guenther, M.D. ’92, MPH

When her mother, a pianist and piano teacher, lost the use of her left hand after a surgery a few years ago, the trauma and sorrow of that experience sent Elisabeth (Lisa) Guenther, M.D. ’92, MPH, on a personal journey that has reshaped her career.

“It was a medical error that was handled incredibly poorly and I thought at the time, I know we can do better than this,” said Dr. Guenther.

Dr. Guenther took up the cause. A pediatric emergency medicine doctor and associate professor of pediatrics at the University of Utah, she buried herself in research on disclosure and medical communication. When she took her mother to Seattle for further treatment, she met with Thomas Gallagher, M.D., a professor at the University of Washington School of Medicine and an authority on ethical issues related to doctor-patient relationships.

“I just cold-called him from my mom’s hospital room and said ‘I want to get involved in this,’ and since then, we’ve been collaborating. It changed my whole research career focus. It’s become my passion to say, okay, we can deliver great medical care, but I want to make sure that we also concentrate on patient-centered communication and honesty and transparency along with it.”

She won a federal planning grant to develop a protocol at the University of Utah for disclosing unanticipated outcomes to patients and their families and embarked on a graduate study program in conflict resolution. “I realized that these are very stressful, loaded interactions for both physicians and patients, and a mediator can play an important role.”

She established a Center for Medical Communication and Conflict Resolution at her medical school and is developing a simulation lab program for medical students and residents there to teach communication skills needed in those difficult conversations.

“Our communication skills not only make for a better medical experience but help improve the safety and quality of the care we provide as well as decrease costs. And it’s definitely a teachable skill.” She cites Joint Commission data showing that poor communication is the number one cause of “sentinel events” – unexpected occurrences involving death or serious physical or psychological injury to a patient.

Dr. Guenther’s journey has come full circle. She was raised in Corvallis, Ore., the child of a now retired math professor at Oregon State University and a woman who not long ago was president of the Oregon Music Teachers Association. During her medical school years in Portland, Dr. Guenther appreciated the collegiality of her class. “We had a wonderful, remarkably tight-knit, hard-working class,” she remembers, with none of the cutthroat competition sometimes found in other medical schools.

Now well into her career, she misses the Northwest, which is why she is pulling up stakes in Utah later this year and transporting her skills and dynamism back to Oregon. She plans to apply them in a still-to-be-finalized effort centered on collaborative disclosure and conflict resolution while remaining a consultant to the center she started in Utah. In this way, she’s spreading the word: physician-patient conversations should heal, not harm, and that’s music to Dr. Guenther’s ears.